What should a physician practice check in a marketing agency contract?
A physician practice should check ten things in a marketing agency contract: term and notice, scope, fees, ad-spend billing, ownership of accounts and provider listings, the Business Associate Agreement, clinical content review, reporting, how payment links to results, and termination and handover. Two clauses matter more for physicians than for most buyers: who owns each provider's online listings, and whether any fee is tied to patient numbers.
- The practice should own everything it pays for: domain, website, Google Business Profiles for the practice and each provider, ad accounts, analytics and call-tracking numbers.
- Fees tied to patient counts need a legal check when Medicare, Medicaid or other federal program patients are involved, because the federal Anti-Kickback Statute bars paying to induce referrals.
- A signed BAA is required if the agency will create, receive, maintain or transmit protected health information, such as call recordings or form submissions.
- A physician should sign off on clinical content before it goes live; the contract should say so and set a review turnaround.
- Every practice welcome — retainers from $499/mo, Goals-Driven engagements, Performance-Linked Payout Models available.
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“They were able to get all my ideas and work with me over a period of three to four months and create this amazing website. It's super customized, very modern, and it incorporates all the elements that I had wanted — the patient portal, nice pictures, a very interactive website, patient reviews. I would highly recommend their company to anyone who wants to make an excellent website.”
Which clauses in a physician practice marketing contract matter most?
Ten clauses decide how much risk a physician practice takes on: term and notice, scope, fees, ad-spend billing, ownership, the BAA, clinical review, reporting, payment structure and exit. Read each one against the table below. If a clause is missing, ask for it in writing before you sign. A gap in the contract usually favors whoever drafted it.
This is a buyer's checklist, not legal advice. Ask a healthcare attorney to review the final contract and the BAA. That matters most for groups, practices with hospital affiliations, and anyone billing federal health programs.
| Clause | What good looks like | Red flag |
|---|---|---|
| Term and notice | Month-to-month, or a short first term with a clear written notice period | Long lock-in that auto-renews unless you cancel inside a narrow window |
| Scope and deliverables | A monthly list of outputs: pages, provider bio updates, profile posts, campaigns, review requests, reports | "Full-service digital marketing" with nothing listed |
| Fees | Fixed management fee, any setup fee, and what triggers a price change | Fees that climb with ad spend and have no cap |
| Ad-spend billing | Charged to the practice's card in its own ad account, or invoiced as a separate pass-through line | One blended invoice you cannot check against Google or Meta billing |
| Ownership | The practice owns the domain, site, every Google Business Profile, ad and analytics accounts, numbers and content | The agency is the sole owner of any profile or account |
| BAA and data | Signed BAA, a named list of tools that touch patient data, no ad pixels on portal or intake pages | "We don't need a BAA, we only do marketing" |
| Clinical review | A physician approves medical content before publishing, with a set turnaround | Condition and treatment pages published with no clinician review |
| Reporting | Defined metrics, a fixed date, and live read access to every account | PDF summaries only, with no access to raw data |
| Payment and performance | Agreed monthly goals and a defined remedy if they are missed | A fee per new patient with no legal review, or guaranteed rankings |
| Termination and handover | Written handover list, access transferred within a set period, numbers ported | "Release fees" to hand back assets you already paid for |
| Non-solicit and IP | Mutual, time-limited staff non-solicit; the practice owns deliverables on payment | A clause that stops you hiring an in-house marketing coordinator |
If you are still comparing agencies, read the red flags when hiring a doctor marketing agency first. Many of those warning signs show up in contract wording.
Who should own provider profiles, ad accounts and phone numbers?
The practice should own every marketing asset it pays for, including a Google Business Profile for each location and each individual provider who has one. The agency should be added as a manager, never the primary owner. The same applies to the domain, hosting, website, ad accounts, analytics, tag manager, call-tracking numbers and all written content.
Why physician practices need extra care
Medical groups often have several kinds of listing: one per location, plus practitioner listings for individual physicians, nurse practitioners and physician assistants. Each one can collect its own reviews and calls. If the agency created those listings under its own login, the practice may struggle to recover them later.
Provider turnover adds a second issue. When a physician leaves, the practice needs a plan for that provider's listing, bio page and any ads that used their name or photo. Put the process in the contract so it is not argued about at the time.
Wording to look for
- "All accounts, domains, listings, content, creative, data and phone numbers created for the Client are the property of the Client."
- "Agency will hold access as a manager or user, not as the primary owner."
- "Call-tracking numbers will be ported or transferred to the Client on request at no additional charge."
- "Provider names, photos and biographies are licensed to Agency only for the term of this agreement."
Website licensing
Some agencies build sites on their own platform and license them to the practice. That can be acceptable, but you need to know before you sign. Ask what leaves with you: the content and images, the full site, or nothing. Get the answer in writing.
Our checklist for switching healthcare marketing agencies covers what to recover if ownership was never written down.
How should fees, ad spend and performance pay be written?
Fees should be split into three visible parts: a fixed management fee, any one-time setup fee and the ad budget. Ad spend should be charged to the practice inside its own ad accounts, or invoiced as a separate pass-through line. Any fee linked to patient volume should be reviewed by healthcare counsel before you sign.
Agency retainers in the US commonly range widely, from a few hundred to many thousands of dollars a month, depending on scope and ad spend. The figure matters less than whether every dollar is traceable. At Ichelon Consulting US, retainers start from $499/month and are custom-scoped, with ad spend billed separately in accounts the practice owns.
Questions to settle in writing
- Is the management fee fixed, or a percentage of ad spend? Is there a minimum and a cap?
- Are landing pages, call tracking, review tools or software seats charged extra?
- When can fees rise, and how much notice is required?
- Is there any charge for ending the contract or for the handover?
The Anti-Kickback question
Some agencies offer to charge per new patient or per booked appointment. For physician practices, that structure needs care. The federal Anti-Kickback Statute (42 U.S.C. § 1320a-7b(b)) is a criminal law that prohibits knowingly and willfully paying remuneration to induce or reward referrals of business paid by federal health care programs. The HHS Office of Inspector General notes that penalties can include fines, prison and exclusion from those programs.
Whether a given marketing fee crosses that line depends on the facts, and many states have their own fee-splitting and anti-kickback rules. This page does not decide that question. If any payment rises or falls with the number of patients, including Medicare or Medicaid patients, have your attorney review it first. A fixed fee with agreed goals avoids most of the uncertainty.
For how pricing models work, see how much a doctor marketing agency costs.
What should the BAA and clinical review terms cover?
A practice needs a Business Associate Agreement when the agency will create, receive, maintain or transmit protected health information on its behalf. For physician practices that often includes call recordings, appointment request forms, patient lists for recall or review requests, and CRM records. The contract should also require physician sign-off on clinical content before it is published.
What the BAA must include
Under 45 CFR § 164.504(e), a business associate contract must, among other things, require the agency to report uses or disclosures the contract does not allow, pass the same restrictions to its subcontractors, and return or destroy protected health information at termination where feasible. It must also let the practice end the contract if the agency materially breaches it. We sign a BAA with every US client.
Data-handling terms to add
- A named list of tools and subcontractors that will touch patient data.
- No advertising pixels on patient portal, intake or appointment request pages.
- Tracking set up in line with the HHS guidance on online tracking technologies. A federal court vacated part of that guidance in June 2024 for unauthenticated public pages, but tracking on authenticated pages such as patient portals is still covered.
- Patient lists used only for the purpose the practice approves, and never uploaded to ad platforms without legal review.
For what to require from vendors in more detail, read HIPAA for marketing agencies and vendors.
Clinical review clause
The physician, not the agency, carries professional responsibility for what the practice says about care. State medical boards also set advertising rules, and they differ by state. The contract should say that a named clinician approves condition, procedure and outcome content, that the agency follows the state board's advertising rules, and how quickly reviews must be returned. Our Virginia physician advertising checklist shows what one state's rules look like in practice.
What should reporting and performance terms say?
Reporting terms should name the cadence, the metrics and your access to raw data. For a physician practice the core metrics are new-patient calls and forms, booked appointments, cost per booked appointment, show rate and the mix of patients by payer type. Performance terms should state goals, how they are measured and what happens when they are missed.
Reporting clause checklist
- Report frequency and the day it arrives.
- Written definitions of a "lead", a "new patient" and a "booked appointment".
- Results split by location and, where useful, by provider.
- Live read access to ad accounts, analytics and call tracking.
- A monthly review with someone who actually works on the account.
Performance terms
No agency can honestly guarantee a map-pack position or a fixed number of patients. Google decides rankings, and the front desk decides how many calls become visits. A sounder structure is agreed monthly goals, tracked openly, with a defined response if a goal is missed. That might be a revised plan, a fee credit or the right to leave early.
We run Goals-Driven engagements: monthly goals agreed with the practice, tracked live on Ichelon Agency OS, with a report every Monday. Performance-Linked Payout Models are also available, scoped with the practice's counsel where federal program patients are involved. See which marketing KPIs a physician practice should track before you agree goals.
If the agency will request patient reviews, the contract should also ban fake or incentivized reviews. The FTC rule banning fake reviews and testimonials took effect in October 2024.
What termination, handover and IP terms protect the practice?
The exit clause should let the practice leave on reasonable notice and get everything back. That means a written handover list, admin access transferred within a set period, exported files and reports, ported phone numbers, and no fee to release assets you already paid for. BAA terms on returning or destroying patient data should apply at the same time.
Handover schedule to attach
- Domain registrar and hosting logins, with the practice as owner.
- Website files, database export and image library.
- Primary ownership of every location and provider Google Business Profile.
- Ad accounts, analytics, tag manager and conversion settings.
- Call-tracking numbers ported to the practice.
- All content, creative, keyword research and reports.
- Written confirmation that patient data has been returned or destroyed.
Non-solicit and IP
A mutual non-solicit of staff is normal. It should be time-limited and should not stop the practice hiring an in-house coordinator. The practice should own all deliverables on payment. The agency may keep its own templates, software and methods, but not your content, data or provider photos.
Before you sign
- Compare the draft with the table at the top of this page.
- Ask for every missing clause in writing.
- Flag any patient-linked fee for legal review.
- Send the final contract and BAA to your attorney.
For a second opinion on a draft, book a call with the US team. You can see our pillar on doctor and primary care marketing in the USA for how we scope physician accounts.
Related pages from the US team
Doctor and primary care marketing USA
How Ichelon Consulting US scopes, contracts and runs physician accounts.
Doctor agency red flags
Warning signs to check before you sign.
Switching agencies
Recover accounts and keep momentum when you change agencies.
Physician agency RFP template
Give every agency the same brief and compare answers fairly.
Every practice welcome — Goals-Driven engagements from $499/mo
We benchmark your last 90 days, agree monthly goals with you, and track them live on Ichelon Agency OS with a report every Monday. Performance-Linked Payout Models are available. Our US leadership is based in Dallas, and strategy calls run in US business hours.
Common questions
Should a physician practice marketing contract be month-to-month?
Month-to-month, or a short first term with a clear notice period, is the safest structure for a physician practice. It keeps the agency accountable every month. A website build can reasonably be a fixed project fee, but the ongoing management retainer should not lock the practice in for long periods or renew automatically without a clear cancellation window.
Who should own a doctor's Google Business Profile?
The practice should be the primary owner of every Google Business Profile it pays to manage, including listings for each location and for individual providers. The agency should be added as a manager. If an agency created a profile under its own account, ask for primary ownership to be transferred to the practice before you sign anything new.
Can a marketing agency charge a physician practice per new patient?
It can raise legal risk. The federal Anti-Kickback Statute prohibits knowingly and willfully paying remuneration to induce or reward referrals of federal health program business, and many states have similar rules. Whether a per-patient marketing fee is a problem depends on the facts, so have healthcare counsel review any fee that changes with patient numbers before signing.
Does a physician practice need a BAA with its marketing agency?
A practice needs a Business Associate Agreement when its marketing agency will create, receive, maintain or transmit protected health information for it. Call recordings, appointment forms, patient lists and CRM records usually qualify. HIPAA rules at 45 CFR 164.504(e) set what the agreement must contain. Ask your attorney to confirm the details for your setup.
Should a physician review marketing content before it is published?
Yes. The physician carries professional responsibility for what the practice says about care, and state medical boards set their own advertising rules. The contract should name a clinician who approves condition, procedure and outcome content, require the agency to follow the state board's rules, and set a turnaround time so reviews do not stall the work.
A note on this guide: it explains marketing practice, not legal advice. Rules on privacy, advertising and insurance change and vary by state, so confirm anything compliance-related with your own counsel.
Reviewing a marketing contract for your practice?
Book a call with the US team. We'll walk through the ownership, billing, BAA and exit clauses in your draft, and show you how we write our own.